Dental
Az Red Mountain Pediatric Dental PLLC
Az Red Mountain Pediatric Dental PLLC was paid $43K by Medicaid between Mar 2018 and Oct 2024, across 13 billing codes. Its largest line is D1120, dental cleaning, child — 31% of everything it billed.
33Billing provider infoAZ RED MOUNTAIN PEDIATRIC DENTAL PLLC
MESA, AZ 85207
MESA, AZ 85207
33aNPI1679027817assigned 08/04/2016
33bProvider typePediatric Dentist
28Total paid$43K
24GClaims7,428
24DCodes billed13
24AFirst – last monthMar 2018 – Oct 2024
Compared with peers
Next to other Pediatric Dentist providers in Arizona
Rank by total paid#100 of 223
Median peer was paid$24K
This provider vs. median1.8×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 74 | $478.72 | |
| 2019 | 274 | $639.62 | |
| 2020 | 1,182 | $2K | |
| 2021 | 1,395 | $5K | |
| 2022 | 1,661 | $13K | |
| 2023 | 1,607 | $12K | |
| 2024incomplete | 1,235 | $10K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D1120 | Dental cleaning, childProphylaxis - child | 31% | 1,265 | 1,238 | $13K |
| D1208 | Topical application of fluoride, excluding varnish | 21% | 1,925 | 1,873 | $9K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 19% | 1,306 | 1,276 | $8K |
| D0272 | Bitewings - two radiographic images | 7.4% | 639 | 621 | $3K |
| D0220 | Intraoral - periapical first radiographic image | 5.5% | 680 | 656 | $2K |
| D0230 | Intraoral - periapical each additional radiographic image | 5.2% | 508 | 488 | $2K |
| D0274 | Bitewings - four radiographic images | 3.0% | 214 | 207 | $1K |
| D0150 | Comprehensive oral evaluation - new or established patient | 2.7% | 127 | 120 | $1K |
| D9230 | Inhalation of nitrous oxide / analgesia, anxiolysis | 1.9% | 169 | 158 | $804.86 |
| D1110 | Prophylaxis - adult | 1.5% | 84 | 77 | $636.29 |
| D2391 | Resin-based composite - one surface, posterior, primary or permanent | 1.0% | 24 | 12 | $451.74 |
| D1999 | 0% | 305 | 268 | $0.00 |
1 more codes
| D0603 | 0% | 182 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialWELCH, JARED (OWNER)